Last weekend, I had the pleasure of meeting and taking the course from the one and only themanualtherapist.com, Dr. Erson Religioso III at Perfect Stride Physical Therapy. I’ve been following his blog for 2+ years and it was great to finally meet him.
The course was excellent overall where Dr. E has allowed me to open my eyes to approaches that I was not a big fan of. I’m not going to write about the whole course but I want to jot down some pointers that I received through out the course.
He started off the course introducing his background and training. While introducing he did A LOT of pain science education. I like a teacher that explains about pain science. You can feel the energy of the room become lighter because it decreased all our threat perception. I was extremely pleased to hear that everything he does is from a neurophysiologic standpoint (including McKenzie End Range Motions), which resonated well with me.
Rest of the weekend included assessment and treatment of the UE/LE utilizing tools such as:
Assessment – SFMA and Repeated Motion Testing
Treatments – Pain education, Home Exercises, Repeated Motion, IASTM and manipulation.
“The biggest difference between you and I is our mouths”- in respect to how we educate and interact with our patients
“I’m evidence lead” <—loved this
“Modern pain science is about setting a painful experience into a positive experience”
“Manual therapy effects has been researched to last for 1~2 hours at best. HEP is a must to keep the therapeutic effect”
“Learn how to decrease the threat of the movement”
By doing the above, the Repeated Motions will become more effective: “End range is where the magic happens”. Or “non-threatening end range is where the magic happens”. He reiterated end range is when the neurophysiological reset happens
“Manual Therapy and exercise are powerful together. Manual therapy, exercises and EDUCATION are even more powerful.”
“Give simple home exercises AND self assessment tools. “
The big take homes points for myself was learning how to get into end range repeated motions. When he explained to the class that he wants to get to end range in a non-threatening way resonated with me much more since it is in alignment with the modern pain research. Many times in the past, I would stop performing repeated motions since the pain continuously got worse or if it did get better extremely high repetitions had to be performed (>200 prone press ups) even to see a result. I was a little too impatient for that.
However, Dr. E utilizes other techniques such as PNF, mobilization/manipulation, IASTM to decrease the nervous systems threat, which allowed the individual to achieve end range quicker and with less pain. When it did reach end range, we did see results repeatedly.
I’ve been utilizing his techniques this week and the results have been very pleasing. My huge goal as a clinician is to start giving self-assessment tools to patients, which I strongly believe will improve my patient compliance. In the end, we are their coaches and our goal as physical therapist is to make them independent.
In summary, I was extremely impressed with his ability to make complex things into such a simple manner and be effective. That’s a sign of a great educator.
Thanks Dr. Erson! I hope to see you in the summer!!!